900 PLAZA #26 - INTERIOR REMODEL �'r S yr
�s\ CITY OF ATLANTIC BEACH
-,. J 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
/ INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-CAAR-2159
Job Type: COMMERCIAL ALTERATION
Description: UNIT#26- INTERIOR REMODEL - CABINETS, TILE, PAINT,
MOVE W/D HOOK UPS
Estimated Value: $7,500.00
Issue Date: 9/28/2015
Expiration Date: 3/26/2016
PROPERTY ADDRESS:
Address: 900 Plaza
RE Number: 171725-0500
PROPERTY OWNER:
Name: SEA OATS ACQUISITIONS, LLC
Address: 645 MAYPORT RD SUITE 5 645 MAYPORT ROAD SUITE 5
GENERAL CONTRACTOR INFORMATION:
Name: MASTER BUILDING CONTRACTORS, LLC
Address: P.O.BOX 11565
JACKSONVILLE, FL 32239
Phone: 904-463-3895
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $43.75
BUILDING PERMIT FEE $87.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $135.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION r �R/I 7 rel nv
CITY OF ATLANTIC BEACH I.,.. V 'i
800 Seminole Road, Atlantic Beach, FL 32233
U At ,' Office (904) 247-5826 Fax (904) 247-5845 • 5 - CA A R-z( 50
Job Address: 00 P 1 Pz-A- IQ 12 1- i DC 1--1 f) Y 73_ Permit Number:
Legal Description St O� 1 5 APP 2TM t- Parcel# ) 7) 75 - O500 702S
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ -7 51k Proposed Work heated/cooled 'i0 non-heated/cooled
Class of Work(circle one): New Addition Alteration R-0ai Move Demolition pool/spa window/door
A i I a T-rj cw7.5
Use of existing/proposed structure(s)(circle one): ommercial Residential
If an existing structure,is a fire sprinkler system insta e r . ire e one): Yes 0 N/
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: PO-) c iT.5 j Louhlrt2 Toes/ T.11-1i.., P r—
yvL 0 0 t A)/'O /106K Vt 195 ,
Property Owner Information:
Name: C.71 off T5 FLQu.t.Wrzom/ - - Address: , l-I Pi i°-y P6 2 j (2-0A-0
City : L TrC 6 M State jZip'J7 Phone 16 4- a`17- 5 3'3'I
E-Mail or Fax#(Optional) 5 7N ' IV)Fr51t12- Bc4 t19-N 6 CorvIt2 fCTcfLS . Cow?
Contractor Information:
Company Name: Ail fl 5 T-"rz gu=Z l2-lh►c,- CbN T. Qualifying Agen : SEA N 06M/US'°'N
Address: 3(°.�9 T F� � City G(74 f Pi-NI VC State r( Zipja
YO/
Office Phone '-I6'1- LAG)-(0 - 15'+14) Job Site/Contact Number 109-LI 63`79 Fax 5- Fax# 14 a 7-42-6- -05 C L $
State Certification/Registration# C9C- I a 5 3 8`I 3
Architect Name&Phone# ?'- I A
Engineer's Name& Phone# N / P(
Fee Simple Title Holder Name and Address 57% M I A5 p,l30vt2
Bonding Company Name and Address 4"
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical-Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that!have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner.•...."....c �•J41—e------ c., a Signature of Contractor
Print Name �,.g2.tp c. A.1 4.*-1/ - Print Name )t7°vN f O
Swo o and subscrib bef re a Sworn to and subsc ed befg a me
r� " d-Q,(t .20
this Day of L �(�U� .20 �� this � � Day of I
`G�-5 115/ A.BINDER .m .y.:.. ).t..:+. �l
��'� Ot•• . -4T.: _State of Florid-
Notary Public , ; - NOTARY PUBLIC r° Elizabeth E Peters
- c STATE OF FLORIDA My Commission EE 172364 Revised 01,26.10
-. �.,. Comm#FF189043 0,op Expires 02/22/2016
4CE 1`1' Expires 1/12/2019
AFTER RECORDING—RETURN TO: FILE ! _OPY
PERMIT NUMBER:/S — :4i - 1.9/s'9)0 01 e 'i Gf 7 P/6 1,?/63., a Y)
/6
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,
Florida Statutes,the following information is provided in this Notice of Commencement. II /l —
I. DESCRIPTION OF PROPERTY(Legal description of the property&street address,if available)TAX FOLIO NO.: ) 1 1 1 2-c DC v Z)
SUBDIVISION BLOCK TRACT LOT BLDG UNIT
iP 0& S ( qUO r[0 7r4 Qfr v. /�v�`� a6, 1010, Lp y, '17 wry 1/
2.GENERAL DESCRIPTION OF IMPROVEMENT: n y mvi /4 o L{ �
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
a.Name and address: Seep D&CC��p/ J�`'i`V,(nVIS4A'W 1ty � �J/��
b.Interest in property: 'ti 3( T O O W! eY/ liD V 1�1 V LL VL U'
c.Name and address of fee simple titleholder(if different from Owner listed above):�/�1 n�/�� ��j L
l ,
4. a.CONTRACTOR'S`NA1ME: M�/�,J/1tt.( f�j^L1 L/(Cl!Vtt 7/0) y Il l'fALIM L vv „�) , j�,•3-- �j]
Contractor's address:3i V L+ ( f JQ. J/ UY 1 V 1 t'u b b.Phone number: q°"t—L(' ly / L C
5. SURETY(if applicable,a copy of the payment bond is attached): "- eta 52 d
a.Name and address:
b.Phone number: c.Amount of bond:$
6.a.LENDER'S NAME: N I
Lender's address: b.Phone number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7.,Florida Statutes: //, 1i �/
a.Name and address: j19.1—...P �//l}}� )tt 14, &l 1 ►V/
b.Phone numbers of designated persons: `mot
8.a.In addition to himself or herself,Owner designates of —I 0 u-, -( 1
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. p
b.Phone number of person or entity designated by Owner: 'f�1/1 Y l pelt t(/) (1't-�1r1'1 i 11 c,Y v ititelplk ttr
9. Expiration date of notice of commencement(the expiration date will be 1 year from the date of recording unless a different date is
specified): ( 1 20_
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13.FLORIDA STATUTES,AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
. WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
L C L s e V P t1J�� &ine�
(Signature of Owner or Lessee,or Owner's or Lessee's ' rint�ame and Provide Signatory's Title/Office)
Authorized Officer/Director/Partner/Manager)
State of 4 ►► �/
County of t//I,I/T {�
The foregoing instrument was ff �'atcknowledged before me this (S` day off+ , �+ ,20}15
n
by V G t C l U,eA,C� ,as � /et 9.IA 1 &/ NI 11C V
for _ �(p_ame o �r}� l ,L Uv C e (type of authorit) e.g.officer,trustee,attorney in fact)
(name of party on behalf of whom instrument was executed)•Personally Known (/or Produced Identi t .ti u , Type of Identification Produced
'�
.spq.Y Pry Notary Public State of Florida , /J�/��IA 1- `^ - (VIM R �� EliZabeIh E I'�tg(s, l�(Z� I(!
• r� Q My Ces 02(2 2 EE 172364
-"top Ao43 Expires 0 212 212 0 1 6 (Signature of N tary Public)
(Print,Type,or Stamp Commissioned Name of Notary Public)
Rev.10-15-12
01.m-* City of Atlantic Beach APPLICATION NUMBER
N$ Pr .6 Building Department a eparmen (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 )5 -LA 1 C�
Phone(904)247-5826 • Fax(904)247-5845
x D;tio• E-mail: building-dept @coab.us Date routed: t. I ( 5
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:tX PL1vzR ZCc;, Depa ent review required Yes No
ilding ✓
Applicant: MAST EK UtL,P1.)C� l 0 N T tannin &Zoning
Tree Administrator
Project: I (\) `[C(Zl0 F., �,Mooe( Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
• Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [pproved. ['Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
Reviewed by: ni Date: 9 v5=45-
TREE ADMIN. Second Review: A roved as revised.
❑ pP ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
revised 07/27/10